{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:19:26Z","timestamp":1789179566409,"version":"build-2803163510"},"reference-count":66,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T00:00:00Z","timestamp":1693008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Children"],"abstract":"<jats:p>Preschool mental disorders are often associated with significant interpersonal problems, related to impaired affect recognition, theory of mind (ToM), and empathy. To date, these skills have not been studied together in preschoolers with externalizing behavior problems (EBPs). The aim of the present study was to investigate whether and to what extent preschool children with EBPs show impairments in affect recognition, ToM, and empathy. Preschoolers with EBPs, defined by current psychiatric treatment and T-scores \u2265 60 on the externalizing problem scale of the Child Behavior Checklist (CBCL\/1\u00bd-5 or 6-18R) were compared to non-clinical controls (HCs), defined by no past and no current psychiatric treatment and T-scores &lt; 60 on all CBCL broad-band scales. Groups were compared on affect recognition (NEuroPSYchological Assessment-II), affective ToM (Test of Emotion Comprehension), cognitive ToM (Extended Theory-of-Mind Scale), parent-reported emotional contagion, attention to others\u2019 feelings, and prosocial action (Empathy Questionnaire), IQ and language (Wechsler Preschool and Primary Scale of Intelligence-III Matrices, Active and Passive Vocabulary test), controlling for age, sex, and language abilities. Compared to 28 HCs, 22 preschoolers with EBPs (total sample meanage = 5.5 years +\/\u2212 0.8 years, range= 4.2\u20136.9 years, males 66%) had significantly greater impairments in cognitive ToM (p = 0.0012, \u03b72 = 0.266), attention to others\u2019 feelings (p = 0.0049, \u03b72 = 0.222), and prosocial action (p = 0.0070, \u03b72 = 0.210), each representing strong effect sizes. EBPs were significantly related to cognitive domains, like prosocial action (r = \u22120.501), cognitive ToM (r = \u22120.425), and attention to others\u2019 feelings (r = \u22120.332), but not to affective domains of social cognition. Social cognitive development may be impaired as early as preschool age and should be promoted before the child starts school.<\/jats:p>","DOI":"10.3390\/children10091455","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T01:56:57Z","timestamp":1693187817000},"page":"1455","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Affect Recognition, Theory of Mind, and Empathy in Preschool Children with Externalizing Behavior Problems\u2014A Group Comparison and Developmental Psychological Consideration"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0368-9279","authenticated-orcid":false,"given":"Laura","family":"Watrin-Avino","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Campus Virchow, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Forbes","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Campus Virchow, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Campus Virchow, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Dittrich","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Campus Virchow, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7254-5646","authenticated-orcid":false,"given":"Christoph","family":"Correll","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Campus Virchow, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"},{"name":"The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY 11004, USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Department of Psychiatry and Molecular Medicine, Hofstra University, Hempstead, NY 11549, USA"},{"name":"The Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"DZPG, German Center for Mental Health, Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bermpohl","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neuroscience, Charit\u00e9 Campus Mitte, Charit\u00e9\u2014University Medicine Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"B\u00f6deker","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9 Campus Virchow, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,26]]},"reference":[{"key":"ref_1","unstructured":"American Psychiatric Association (2000). 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